Issue of January 14, 2018

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PHIC fee hike effective Jan 1
by Hanna C. Lacsamana

Members of the Philippine Health Insurance Corp. (PhilHealth) will pay higher monthly premium contributions starting this month as a result of the health insurance arm’s adjustment in rates to sustain its health programs.

PhilHealth Cordillera Information Officer Maggie del Rosario said Memorandum Circular 2017-0024 issued on September last year states that the monthly premium contributions shall now be at the rate of 2.75 percent of the monthly basic salary with a salary floor of P10,000 and a ceiling of P40,000, to be equally shared by the employees and their employer.

The rate adjustment, by .25 percent from the previous 2.5 percent, is provided in the National Health Insurance Act of 2013’s Implementing Rules and Regulations, which exacts contribution from its members not exceeding five percent of the employee’s monthly salary.

The circular covers all employed members in the formal economy, including kasambahays, family drivers, and sea-based overseas Filipino workers, and all employers in the government and private sectors.

This means that an employee receiving P10,000 and below monthly pay will have a premium of P275, P137.50 of which is shouldered as employee’s personal share and P137.50 employer’s share. Monthly premiums of those receiving P10,000.01 to P39,999.99 range from P275.02 to P1,099.99 and those with P40,000 and above salary will have a monthly premium of P1,100.

The premium contributions of the kasambahay shall be shouldered solely by the household employer, but if the kasambahay receives P5,000 or above monthly, then he/she shall pay their proportionate share.

“This (monthly premium adjustment) should not be construed as an increase, because it is still within the ceiling of up to five percent of a member’s basic monthly salary, and it also has nothing to do or related with the increases brought about by the Tax Reform Law,” del Rosario said.

She stated four reasons for the rate adjustment.

First, the raise is needed for the soon-to-be implemented Primary Care Benefit Package for non-indigents, currently covering indigents and marginalized sectors, which provides free checkup in health facilities and help lessen the number of individuals going to hospitals.

“Formal members or non-indigents will now also be enjoying the PCB package,” del Rosario explained.

The adjustment is also for the expansion of the Z Benefit Package given to members with catastrophic illnesses such as cancer, kidney transplantation, and heart bypass. Del Rosario said more types of illnesses will soon be included in the package.

Third, the adjustment shall also cover health benefits for the increasing number of senior citizens, which according to latest Commission on Population data are now at eight million. PhilHealth, del Rosario said, is mandated to provide senior citizens free health care and no balance billing services whether they are PhilHealth member or not.

Further, the rate increase is for the enhanced case rates PhilHealth program, wherein each illness has a corresponding fixed amount that a member is entitled to. It covers medicines, professional fee, operating room fee, and other services. “We continuously upgrade the care rate amount of each illness to match with hospital expenses,” she said.

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